T90-T98
Medium Complexity

Other and unspecified effects of external causes

Primary Specialty: Physical Medicine and Rehabilitation
Last Updated: 2025-09-09

ICD-10 Codes (0)

0 billable
0 category headers

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Updates & Changes

FY 2026 Updates

Current Year

New Codes (2)

T40.411A
Poisoning by fentanyl, accidental (unintentional), initial encounter
T40.491A
Poisoning by other synthetic narcotics, accidental (unintentional), initial encounter

Revised Codes (1)

T40.2X1A
Poisoning by other opioids, accidental (unintentional) - updated to include synthetic opioid specifications

Deleted Codes

No codes deleted in this range for FY 2026

Historical Changes

  • FY 2025: Routine maintenance updates with minor terminology clarifications
  • FY 2024: Enhanced specificity requirements for certain code ranges
  • FY 2023: Updated documentation guidelines for improved clarity

Upcoming Changes

  • Proposed updates pending review by Coordination and Maintenance Committee
  • Under consideration: Enhanced digital health integration codes

Implementation Guidance

  • Review all FY 2026 updates for T90-T98 codes before implementation
  • Always verify the most current codes in the ICD-10-CM manual
  • Ensure clinical documentation supports the selected diagnosis codes
  • +3 more guidance items...

Range Overview

high priority

The ICD-10 category T90-T98, 'Other and unspecified effects of external causes,' encompasses codes that document the late effects of injuries, poisonings, and other consequences of external causes. These codes are used when the acute phase of an injury or poisoning has resolved but residual effects remain. It is important to note that these codes are not used for the initial injury or poisoning event, but for subsequent medical encounters when the patient is receiving care for the long-term effects.

Key Usage Points:

  • These codes are used for follow-up visits after the acute phase of an injury or poisoning.
  • The codes are not used for the initial injury or poisoning event.
  • The codes can be used for any residual effects, regardless of the time elapsed since the initial event.
  • The codes should be sequenced following the underlying condition code.
  • The codes can be used in conjunction with other codes to provide a more detailed picture of the patient's condition.

Coding Guidelines

When to Use:

  • When a patient is being treated for the late effects of a burn.
  • When a patient is receiving care for the residual effects of a poisoning incident.
  • When a patient is being treated for complications from a previous injury.
  • When a patient is receiving care for the long-term effects of an external cause.

When NOT to Use:

  • When the patient is being treated for the initial injury or poisoning event.
  • When the patient has fully recovered from the injury or poisoning with no residual effects.
  • When the patient's condition is not due to an external cause.
  • When the patient's condition is due to an internal cause.

Code Exclusions

Always verify exclusions with the patient's medical record and the official ICD-10 coding guidelines.

Documentation Requirements

Documentation for these codes should include a detailed description of the patient's condition, the residual effects of the injury or poisoning, and the treatment provided. The documentation should also clearly indicate that the condition is a late effect of an external cause.

Clinical Information:

  • Detailed description of the patient's condition
  • Description of the residual effects of the injury or poisoning
  • Treatment provided
  • Indication that the condition is a late effect of an external cause

Supporting Evidence:

  • Medical history
  • Physical examination findings
  • Laboratory and diagnostic test results
  • Progress notes
Good Documentation Example:

Patient is being treated for residual effects of a burn sustained 2 years ago. The burn has healed, but the patient has ongoing pain and limited mobility in the affected area.

Poor Documentation Example:

Patient is being treated for burn.

Common Documentation Errors:

  • Not documenting that the condition is a late effect of an external cause
  • Not providing a detailed description of the patient's condition
  • Not documenting the treatment provided
  • Not including supporting evidence

Range Statistics

11
Total Codes
0
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:

Coding Complexity

Medium
Complexity Rating

Coding for these conditions can be complex due to the need to determine whether the condition is a late effect of an external cause, identify the residual effects of the injury or poisoning, sequence the codes correctly, navigate the exclusions, and document the condition and treatment accurately.

Key Factors:
  • Determining whether the condition is a late effect of an external cause
  • Identifying the residual effects of the injury or poisoning
  • Sequencing the codes correctly
  • Navigating the exclusions
  • Documenting the condition and treatment accurately

Specialty Focus

These codes are commonly used in specialties that treat patients with long-term effects of injuries or poisonings, such as physical medicine and rehabilitation, pain management, and neurology.

Primary Specialties:
Physical Medicine and Rehabilitation
40%
Pain Management
30%
Neurology
30%
Clinical Scenarios:
  • Patient with chronic pain due to a previous burn injury
  • Patient with neurological complications from a previous traumatic brain injury
  • Patient with mobility issues due to a previous fracture
  • Patient with respiratory issues due to a previous inhalation injury
  • Patient with psychological issues due to a previous poisoning incident

Resources & References

There are many resources available to help with coding these conditions, including the official ICD-10 coding guidelines, clinical reference books, and educational materials.

Official Guidelines:

  • Official ICD-10 coding guidelines
  • ICD-10-CM Official Guidelines for Coding and Reporting
  • ICD-10-CM Expert for Hospitals

Clinical References:

  • Clinical reference books
  • Medical journals
  • Online medical databases

Educational Materials:

  • Coding webinars
  • Coding workshops
  • Online coding courses

Frequently Asked Questions

Can these codes be used for the initial injury or poisoning event?

No, these codes are used for subsequent medical encounters when the patient is receiving care for the long-term effects of an injury or poisoning.